| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES, INC. | 2290 HUNTINGON DRIVE, SUITE 200 SAN MARINO, CA 91108 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $391 | $5K | 13.49% |
| AMWINS3 Filed as: LISI LLC | 2677 NORTH MAIN STREET, SUITE 800 SANTA ANA, CA 92705 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $236 | $2K | 6.10% |
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES, INC. | 80 SOUTH LAKE AVENUE, SUITE 600 PASADENA, CA 91101 | METROPOLITAN LIFE INSURANCE COMPANY | $763 | $0 | $763 | 2.17% |
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES, INC. | 2290 HUNTINGON DRIVE, SUITE 200 SAN MARINO, CA 91108 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $2K | $294 | $2K | 10.18% |
| AMWINS3 Filed as: LISI LLC | 2677 NORTH MAIN STREET, SUITE 800 SANTA ANA, CA 92705 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $1K | $123 | $1K | 5.98% |
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES, INC. | 80 SOUTH LAKE AVENUE, SUITE 600 PASADENA, CA 91101 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $471 | $0 | $471 | 1.98% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 192 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 192 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 253 | $59K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 253 | $35K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 253 | $35K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 253 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 253 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.